Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02665 | Date 30/07/2019 |
| Token No | SM/18-19/5392 03/08/2019 | Serial | 019 |
| Patient Name | Mrs. SIMA SARKAR | Contact No | 8100375760 |
| Address | AROBINDA PARK | Age | 42 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||